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Case Report
DOI: 10.7241/ourd.20132.52
RECURRENT ECCRINE HIDRADENOMA OF
THE BREAST IN A MALE PATIENT: PROBLEMS IN
DIFFERENTIAL DIAGNOSIS
Maria Orsaria, Laura Mariuzzi
Source of Support:
Nil
Competing Interests:
None
Department of Pathology, University Hospital of Udine, 33100 Udine, Italy
Corresponding author: Dr Maria Orsaria
mariaorsaria@yahoo.it
Our Dermatol Online. 2013; 4(2): 215-217 Date of submission: 10.01.2013 / acceptance: 13.02.2013
Abstract
Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly.
Case report: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor,
measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination
concluded to an eccrine hidradenoma with clear cells.
Conclusion: Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal
carcinoma or adenomyoepitelioma), from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient
presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the
literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.
Key words: eccrine hidradenoma; breast; clear cell; recurrence
Cite this article:
Maria Orsaria, Laura Mariuzzi: Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis. Our Dermatol Online. 2013;
4(2): 215-217.
Introduction
Hidradenoma is a benign adnexal neoplasm, mostly
dermal located, historically considered eccrine, but with
evidences suggesting also an apocrine differentiation [1].
This neoplasia presents most often in young adults, and
appears to be slightly more common in women than in
men. Common locations are head, neck and limbs [2]. The
histologic appearance put in the differential diagnosis other
skin neoplasms and other tumors depending on the location
[3-6]. These tumors are usually benign but they can have
rarely low malignant potential, and they should be surgically
removed with safety margins, because they have a high local
recurrence rate and a potential of malignant transformation
[7].
Case Report
A 39-year-old man presented with a recurrent nodule of
the left outer upper left breast quadrant, superficially located.
The lesion was asymptomatic. He reported a previous
history of a excised breast mass in the same location. No
clinical-pathological report of the prior resection was
available. Physical examination revealed a solitary, wellcircumscribed
tumor, measuring 1 cm by 0.7 cm. No other
skin abnormalities were found. The tumor was excised and
submitted for histological examination.
Tissues were fixed in buffered formalin, paraffin embedded
and routinely processed for histological diagnosis. For
immunohistochemistry, the Dako REAL EnVision
Detection System, Peroxidase/DAB+, Rabbit/Mouse Code
K5007 method was used. The antisera employed are listed
in Table I, together with their source, dilution and antigen
retrieval method.
Results
The histopathological result of a needle core biopsy
showed a tumor composed of solid sheets of clear cells with an
abundant vascularization; the subsequent excisional biopsy
(Fig. 1) revealed a lobulated masses in the dermis with focal
extension into the subcutaneous fat, without connection with
the above skin, composed of two cell types (Fig. 2 a, b): a
population of cuboidal cells with eosinophilic cytoplasm and
round to oval nucleus with conspicuous nucleolus; elsewhere
it consisted of cells with clear cytoplasm containing large
glycogen deposits and with a small eccentrically located
nucleus. No mitosis were found. Focally, duct-like structures
were present, lined by cuboidal cells resulting in perivascular
pseudorosettes. The tumor lobules were surrounded by a
desmoplastic stroma. No breast ductules were found in
proximity of the tumor lobules.
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